ABSTRACT
Facial nerve neurinoma is a benign tumor, infrequent and exceptional in children. It's clinical manifestation depends on its location and extension, facial palsy being its most frequent sign. Complementary examinations, namely image-diagnosis studies and audiometric tests become essential. Certain diagnosis is made by pathological anatomy. The reported case is a 13-year-old patient suffering from left peripheral facial palsy with an evolution of 8 months who went through a middle cerebral fossa and transmastoid combined tract.
Subject(s)
Cranial Nerve Neoplasms/diagnosis , Facial Nerve Diseases/diagnosis , Facial Nerve , Neurilemmoma/diagnosis , Adolescent , Cranial Nerve Neoplasms/pathology , Cranial Nerve Neoplasms/surgery , Diagnosis, Differential , Facial Nerve Diseases/pathology , Facial Nerve Diseases/surgery , Facial Paralysis/diagnosis , Facial Paralysis/etiology , Humans , Magnetic Resonance Imaging , Male , Neurilemmoma/pathology , Neurilemmoma/surgery , Tomography, X-Ray ComputedABSTRACT
The association between arteriovenous malformations (AVM's) and aneurysms is well documented in the literature. However, a specific type of aneurysm, termed a "pedicle" aneurysm, has received little attention despite its role as a primary source of hemorrhage. The authors report four recent cases of patients with cerebral AVM's who bled from aneurysms arising from the midportion of AVM-feeding artery pedicles. Angiography, computerized tomography, and magnetic resonance imaging confirmed the origin of the hemorrhage from the pedicle aneurysm in each case. Because pedicle aneurysms are at risk for recurrent rupture, they represent an important subclassification of aneurysms associated with AVM's. The authors have expanded the previous classification systems for aneurysms associated with AVM's to include pedicle aneurysms; this classification is based on the location of the aneurysm and its relationship to the malformation. Complete documentation of such aneurysms as the potential source of hemorrhage is recommended, and prompt intervention by embolization and/or surgical resection is indicated for this dangerous aneurysm associated with cerebral AVM's.